On the question of whether the state has ever funded gender transition surgeries for incarcerated people, Leah Boggs, general counsel to the Justice and Public Safety Cabinet, had a straightforward answer for lawmakers.
"No... gender-affirming surgery has happened, did happen, will happen," she told the Administrative Regulation Review Subcommittee on Monday.
But the matter gets more complicated when the issue is hormone therapy.
Of the nearly 1,300 inmates in the Department of Corrections, Boggs reported that 467 are receiving some kind of hormone treatment. The number includes those with a variety of medical conditions. Looking solely at inmates on hormone therapy for gender dysphoria, the number is currently 67, she said.
And those cases require physician approval. Under the updated regulation, that policy would continue.
Sen. David Yates, a Louisville Democrat, worried aloud about ensuring the judgment of doctors wasn't being overruled by opinions of non-physicians in Corrections.
"I always think that we get into a dangerous territory, and I'm looking at litigation whenever states or even the Department of Corrections would try to make a determination of which medicine they're going to supply to inmates based on their own belief of what's reasonable and necessary," he said.
Republicans have been highly critical of the original question raised by the regulation, with most of their focus on surgeries and whether taxpayer funds might be involved. Lawmakers have questioned the timing of the request for an AG opinion, years after the draft regulations process began.
"I don't think the taxpayers of Kentucky are really interested in paying for hormone replacement therapy or transgender surgeries for people who have been found guilty of committing crimes against the commonwealth," then-Sen. Damon Thayer said during the initial conversation in committee.
In addition to the Department of Corrections, GOP leaders also pushed for answers from the state's Democratic governor, Andy Beshear.
Beshear told reporters during a briefing that he does not support the inclusion of such surgeries in the rules, pointing out that it would mean inmates were receiving better health coverage than law-abiding citizens.
On Monday, the department's attorney said the hormone drugs, which are paid for by the state, are not itemized — meaning no specific dollar amounts were provided for the hormone drugs purchased for inmates diagnosed with gender dysphoria.
Lawmakers appeared mostly comfortable with the new regulatory language, though it could face further scrutiny or become the target of legislation during the current General Assembly.
The regulation now moves to its committee of jurisdiction.
